Diagnostic outcomes of radial endobronchial ultrasound bronchoscopy guided by manual navigation in the evaluation of peripheral pulmonary lesions: An observational study

IF 1.9 4区医学 Q3 RESPIRATORY SYSTEM

Clinical Respiratory Journal Pub Date : 2024-04-29 DOI:10.1111/crj.13768

Mingli Yuan, Yi Hu, Liangchao Wang, Wen Yin, Yang Xiao

{"title":"Diagnostic outcomes of radial endobronchial ultrasound bronchoscopy guided by manual navigation in the evaluation of peripheral pulmonary lesions: An observational study","authors":"Mingli Yuan, Yi Hu, Liangchao Wang, Wen Yin, Yang Xiao","doi":"10.1111/crj.13768","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Aims</h3>\n \n <p>Manual navigation (MN), drawing a bronchoscopic road map simply by looking at the consecutive computed tomography (CT), is feasible and economical. However, scant data about the use of MN in radial endobronchial ultrasound (r-EBUS) bronchoscopy have been documented till now. We aimed to evaluate the diagnostic performance of r-EBUS bronchoscopy guided by MN for diagnosing peripheral pulmonary lesions (PPLs) and to determine clinical factors affecting the diagnostic yield.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We performed a retrospective, cohort study of consecutive patients with PPLs who underwent r-EBUS bronchoscopic biopsy via guidance of MN from May 2020 to June 2021 in our Respiratory Endoscopic Division. The overall diagnostic yield of MN-guided r-EBUS, the factors affecting the yield, and the diagnostic performance for malignancy were evaluated.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 102 patients (103 lesions) were evaluated. The overall diagnostic yield of MN-guided r-EBUS was 82.0%, and it ranged from 79.6% to 82.5%, assuming the undermined cases were all positive cases (79.6%) or negatives (82.5%). The sensitivity of MN-guided r-EBUS for malignancy was 71.4%, ranging from 68.2% to 71.4%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 67.3%, ranging from 63.8% to 69.0%. The multivariate logistic regression showed that “bronchus sign on CT” was the only predictor of the overall diagnostic yield (odds ratio = 11.5, 95% confidence interval: 1.9–70.9, <i>P</i> = 0.009).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>MN-guided r-EBUS is feasible in diagnosing PPLs, especially for lesions with bronchus sign on CT.</p>\n </section>\n </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.13768","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Respiratory Journal","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/crj.13768","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}

引用次数: 0

Abstract

Background and Aims

Manual navigation (MN), drawing a bronchoscopic road map simply by looking at the consecutive computed tomography (CT), is feasible and economical. However, scant data about the use of MN in radial endobronchial ultrasound (r-EBUS) bronchoscopy have been documented till now. We aimed to evaluate the diagnostic performance of r-EBUS bronchoscopy guided by MN for diagnosing peripheral pulmonary lesions (PPLs) and to determine clinical factors affecting the diagnostic yield.

Methods

We performed a retrospective, cohort study of consecutive patients with PPLs who underwent r-EBUS bronchoscopic biopsy via guidance of MN from May 2020 to June 2021 in our Respiratory Endoscopic Division. The overall diagnostic yield of MN-guided r-EBUS, the factors affecting the yield, and the diagnostic performance for malignancy were evaluated.

Results

A total of 102 patients (103 lesions) were evaluated. The overall diagnostic yield of MN-guided r-EBUS was 82.0%, and it ranged from 79.6% to 82.5%, assuming the undermined cases were all positive cases (79.6%) or negatives (82.5%). The sensitivity of MN-guided r-EBUS for malignancy was 71.4%, ranging from 68.2% to 71.4%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 67.3%, ranging from 63.8% to 69.0%. The multivariate logistic regression showed that “bronchus sign on CT” was the only predictor of the overall diagnostic yield (odds ratio = 11.5, 95% confidence interval: 1.9–70.9, P = 0.009).

Conclusions

MN-guided r-EBUS is feasible in diagnosing PPLs, especially for lesions with bronchus sign on CT.

Abstract Image

查看原文本刊更多论文

人工导航引导下的径向支气管内超声支气管镜在评估肺部外周病变时的诊断结果：观察性研究

背景和目的手动导航（MN），即通过观察连续的计算机断层扫描（CT）绘制支气管镜路线图，既可行又经济。然而，到目前为止，有关在径向支气管内超声（r-EBUS）支气管镜检查中使用手动导航的数据还很少。我们的目的是评估 MN 引导下的 r-EBUS 支气管镜诊断周围肺部病变（PPL）的性能，并确定影响诊断率的临床因素。方法我们对 2020 年 5 月至 2021 年 6 月期间在本院呼吸内镜科接受 MN 引导的 r-EBUS 支气管镜活检的连续 PPLs 患者进行了一项回顾性队列研究。评估了 MN 引导 r-EBUS 的总体诊断率、影响诊断率的因素以及对恶性肿瘤的诊断效果。结果共评估了 102 名患者（103 个病灶）。MN-guided r-EBUS的总体诊断率为82.0%，假定被破坏的病例均为阳性病例（79.6%）或阴性病例（82.5%），诊断率在79.6%至82.5%之间。MN引导下的r-EBUS对恶性肿瘤的敏感性为71.4%，介于68.2%和71.4%之间，特异性为100%，阳性预测值为100%，阴性预测值为67.3%，介于63.8%和69.0%之间。多变量逻辑回归显示，"CT 显示支气管征象 "是唯一能预测总体诊断率的因素（几率比 = 11.5，95% 置信区间：1.9-70.9，P = 0.009）。结论 MN引导下的r-EBUS可用于诊断PPL，尤其是CT上有支气管征的病变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical Respiratory Journal 医学-呼吸系统

CiteScore

3.70

自引率

0.00%

发文量

104

审稿时长

>12 weeks

期刊介绍： Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)

文献相关原料

公司名称	产品信息	采购帮参考价格